Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very low-carbohydrate and high-fat ketogenic diet. Russel Wilder first used the ketogenic diet to treat epilepsy in 1921. He also coined the term “ketogenic diet.”
A ketogenic diet primarily consists of high fats, moderate proteins, and very low carbohydrates. The dietary macronutrients are divided into approximately 55% to 60% fat, 30% to 35% protein, and 5% to 10% carbohydrates. Specifically, in a 2000 kcal per day diet, carbohydrates amount up to 20 to 50 g per day.
A period of low carbohydrate ketogenic diet may help to control hunger and may improve fat oxidative metabolism and therefore reduce body weight. Furthermore, new kinds of ketogenic diets using meals that mimic carbohydrate-rich foods could improve compliance with the diet. Attention should be paid to the patient’s renal function and to the transition phase from the ketogenic diet to a normal diet that should be gradual and well-controlled. The duration of the ketogenic diet may range from a minimum (to induce the physiological ketosis) of 2–3 weeks to a maximum (following a general precautionary principle) of many months (6–12 months).
Some negative side effects of a long-term ketogenic diet have been suggested, including an increased risk of kidney stones and osteoporosis and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important not solely to focus on eating high-fat foods but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.
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A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. The exact ratio of fat, carbohydrates, and protein that is needed to achieve health benefits will vary among individuals due to their genetic makeup and body composition. Therefore, if one chooses to start a ketogenic diet, it is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications. A dietitian may also provide guidance on reintroducing carbohydrates once weight loss is achieved.
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